Roles of Pro- and Anti-inflammatory Cytokines in Traumatic Brain Injury and Acute Ischemic Stroke

This chapter will introduce the reader to the pathophysiology of two devastating neurologic events, traumatic brain injury (TBI) and acute ischemic stroke (AIS). Here we focus on the role of key pro-inflammatory and anti-inflammatory cytokines. Several experimental interventions have been found to modulate cytokine production and brain injury after AIS or TBI. Here minocycline, biological response modifiers, hormonal therapies, omega-3 fatty acids, N-acetylcysteine, and cannabinoids will be discussed. In addition, the role of cytokine-induced inflammasomes in both TBI and AIS will be addressed and followed by discussion of pro-inflammatory cytokines (e.g., TNF-α, IL-1β, IL-18, and IFN-γ). Finally, the main anti-inflammatory cytokines, IL-33, IL-10, IL-6, and IL-4, will be discussed in the context of both TBI and AIS. It should be noted that the role of these cytokines is diverse and the dichotomization of classically pro-versus anti-inflammatory cytokines is being re-examined, as many of these cytokines have been found to play dual roles in TBI and AIS brain injury.